Symposium report: breast cancer in India—trends,environmental exposures and clinical implications

Cancer Causes & Control - Incidence of breast cancer (BC), particularly in young women, are rising in India. Without population-based mammography screening, rising rates cannot be attributed to...     

Cancer vascularization: implications in radiotherapy?

PURPOSE: Although hypoxia is considered a major cause of failure of radiotherapy, the mechanisms of tumor hypoxia are unclear, and effective ways for its correction or targeting are missing. Tumoral vasculature is the vehicle for the hemoglobin to reach the tumoral stroma. Although anemia has long been focused on as an important parameter related to tumor hypoxia, differences in vascular density may also affect the intratumoral access of hemoglobin. METHODS AND MATERIALS: In the present study, we examined the vascular density in 1459 human carcinomas. The distribution of the vascular density within tumors was studied in 436 non-small-cell lung carcinomas and 298 breast carcinomas. RESULTS: The vascular density was found to vary up to 22-fold even among tumors of the same histology. Overall, the vascular density was significantly higher in the tumor periphery as compared to inner areas. Three different patterns of vascularization were identified in both lung and breast cancer specimens; (1) tumors with low or (2) tumors with high vessel density throughout the tissue section, and (3) tumors with high vessel density in the tumor periphery and low in inner areas. The death rate following surgery showed a direct association with the vascular density in lung, breast, colon, and endometrial cancer. In inoperable gastric cancer patients treated with chemotherapy, and in head and neck cancer patients treated with radical chemoradiotherapy there was a 'U-like' association of the death rate with the vascular density suggesting that very low (poor oxygen and drug availability) and very high (intensified angiogenic pathways) vascularization are both linked to poor outcome. CONCLUSION: The present study stresses the importance of the vascular density as a putative variable that may have affected the results of large clinical trials that investigated the role of anemia, hyperbaric oxygen, hypoxic sensitizers, or even of combined chemoradiotherapy in the outcome of radiation treatment.     

Dermatofibrosarcome de Darier-Ferrand: deux cas à localisation cervicofaciale

The authors illustrate the diagnostic and therapeutic difficulties encountered with Darier and Ferrand dermatofibrosarcoma from 2 cases report. Patients were 40 and 31 years old. In the first case, the tumour had been evolving for 4 years and occupied the submandibular region. In the second case, it had been evolving for 14 years and was localized in the parotido-submandibular region. The two patients benefitted from at least a biopsy or a partial surgical gesture before admission in our service. Surgical excision was wide. Both patients are alive after 4 and 2 years without recurrence and metastasis. Darier and Ferrand dermatofibrosarcoma is a cutaneous tumour of local malignancy, often diagnosed after several recurrences. The best treatment is surgery and consists in a wide and deep excision sacrificing healthy tissue.     

Angiosarcome du sein : à propos de deux cas

Angiosarcoma is a rare type of breast cancer; it has the worst prognosis of all breast malignancies and it is difficult to diagnose. Its definition is pathological; it is a primary malignant proliferation of endothelial cells of vascular tissue of the mammary gland. We report two cases of breast angiosarcoma observed at the Maternity of Oranges and at the National Institute of Oncology. The preoperative diagnosis was raised on the clinical and pathological data. The treatment was essentially surgical. The evolution was marked by complete remission in both cases. In light of these two observations and the literature review, we tried to update on the various aspects of this disease.     

Contralateral prophylactic mastectomy and survival: report from the National Cancer Data Base, 1998–2002

The use of contralateral prophylactic mastectomy (CPM) has been increasing despite questionable survival benefit. We examined the effect of CPM on survival using the National Cancer Data Base. We examined overall survival on 219,983 mastectomy patients diagnosed with unilateral AJCC Stage 1–III invasive breast cancer between 1998 and 2002 of which 14,994 (7 %) underwent CPM at the time of their index mastectomy. Median follow up time was 5 years. Neoadjuvant and locally advanced breast cancers were excluded. Approximately 4 % underwent CPM in 1998 compared to 9.4 % in 2002, an ~125 % increase. CPM patients were significantly younger than non-CPM patients, on managed care plans, and were treated at high volume centers. The unadjusted hazard ratio (HR) of death was 0.55 (95 % CI 0.52–0.57) for CPM compared to unilateral mastectomy. In a multivariable Cox model adjusting for age, race, stage, grade, histology, insurance, facility characteristics, use of adjuvant hormonal, chemotherapy, and radiotherapy, and year of diagnosis, the adjusted HR was 0.88 (95 % CI 0.83–0.93; p < 0.001) which translated into an absolute 5-year benefit of 2 %. There was a differential effect of CPM by stage and age: HR = 0.88 (95 % CI 0.82–0.94; p < 0.001) in women younger than 70 with stage I/II, and HR = 0.95 (95 % CI 0.88–1.04; p = 0.28) in women with stage III or older than age 69 which translated into an absolute 5-year benefit of 1.3 %. Utilization of hormonal therapy or chemotherapy had no effect on the HR. After adjusting for confounding, the overall survival benefit for CPM is minimal at best.     

The clinicopathological characteristics and surgical treatment of retroperitoneal angiomyolipoma： a case report and literature review of both English and Chinese

Angiomyolipoma usually present as incidental findings on routine imaging or laparotomy, but rarely they may give rise to massive hemorrhage. If bleeding occurs, the treatment of choice is to save life either by angiography with selective embolisation or surgery. Herein, we reported a case of a 32-year-old man who came to our hospital complaining of sudden colicky pain in the right hypochondria region, associated with nausea and vomiting. On physical examination, the patient was in a state of shock; blood pressure of 60/36 mmHg, heart rate of 160 beats/min, high abdominal distention, and non-coagulated blood was extracted from abdominal puncture. The abdominal computed tomography (CT) and arteriography showed a 20 × 15 × 15 cm mass suggestive of spontaneous rupture of liver neoplasm and intraperitoneal hemorrhage. On laparotomy, 1500 mL of non-coagulated blood was found, and the tumor located at right upper abdomen, which originated from retroperitoneum. The tumor was resected totally with hematoma and sutured the bleeding vessels. The histological study of the resected mass revealed the presence of angiomyolipoma.     

Radiation-induced cerebellar high-grade glioma accompanied by meningioma and cavernoma 29 years after the treatment of medulloblastoma: a case report

Here, we report the case of a patient with cerebellar high-grade glioma that developed after the patient underwent treatment for medulloblastoma. A 34-year-old man visited our hospital with complaints of dizziness and truncal ataxia. Magnetic resonance image showed a cerebellar tumor with multiple cavernomas and two lesions that were suspected to be meningiomas. The cerebellar tumor was surgically removed. According to pathological examination, the tumor was a high-grade glioma that was positive for methylated O-6-methylguanine-DNA methyltransferase promoter. In the past, he had received radiotherapy at the age of 5, after which he was operated for desmoplastic medulloblastoma in his right cerebellar hemisphere. Seven years after the initial therapy, cavernoma-induced intracerebral hemorrhage of the right temporal lobe was noted. To our knowledge, this is the first case of radiation-induced double intracranial tumors accompanied by symptomatic cavernoma.     

Schwannome mammaire bénin : à propos de deux cas

Schwannoma is a rare nervous tumor developed on schwan cells. It occurs usually in the extremities, the trunk and the head region. Its occurrence in the breast is rare with only a few cases being reported. It usually appears as a breast lump having clinical and radiological characteristics suggestive of benign lesions. Its diagnosis is histological. Its treatment is surgical. Through two observations and a literature review we would try to remind the characteristics of this tumor and its management.     

Crohn’s disease with infliximab treatment complicated by rapidly progressing colorectal cancer: A case report

BACKGROUNDCrohn''s disease (CD) causes a range of digestive symptoms including recurrent diarrhea, abdominalgia, and flatulence, and severely impacts the quality of life of patients. Infliximab, a monoclonal antibody against tumor necrosis factor alpha, has recently been promoted as a therapeutic treatment for CD, but its safety margins remain uncertain. We report a case of rapidly progressive colorectal cancer that was diagnosed in a patient with CD who had previously been treated with infliximab.CASE SUMMARYThis case report refers to a 40-year-old male with a 6-year history of CD. The patient underwent transverse colostomy because of inflammatory ileus in 2017. He subsequently received infliximab treatment in 2018. Ten months later, worsening contracture of the transverse colostomy was observed. Imaging tests indicated that the patient may have developed colon cancer with extensive peritoneal implantation. At the same time, colonoscopy revealed a rectal mass and pathological examination indicated well-differentiated adenocarcinoma. Palliative ileostomy was performed to improve defecation in 2019. During the operation, a small nodular mass in the mesentery of the small intestine was identified and pathological examination of the mass revealed advanced adenocarcinoma. The patient was diagnosed with advanced colorectal cancer and administered palliative chemotherapy. He died in June 2020.CONCLUSIONWe stress the importance of recognizing the possible occurrence of malignance in patients with CD receiving infliximab.     

Solitary Langerhans cell histiocytosis of frontal lobe: a case report and literature review

The brain parenchymal Langerhans cell histiocytosis （LCH） without systemic disease or lytic skull lesions is extremely rare. We report a 23-year-old male presenting with new onset 1 hour seizure with loss of consciousness 20 days prior to admission, and recurrent seizure 2 weeks later. Brain magnetic resonance imaging （MRI） showed an irregularly mass with enhancement involving the right frontal lobe. Microscopically, the lesion was characterized by sheets of Langerhans cells in addition to reactive inflammatory elements. Immunohistochemically, Langerhans cells were positive for Langerin, CDla and S-100 protein. The patient received no chemotherapy or radiotherapy after surgery. After 24 months of follow-up, no recurrence or other systemic lesions were observed. Although there is no standard treatment for solitary cerebral LCH, the prognosis generally appears to be good.     

Pancreatic head carcinoma and right hepatic artery: embolization management—A case report

A replaced right hepatic artery (RHA) is the most common anatomical variation in pancreatic surgery. The RHA is frequently encountered and can be problematic in pancreatic carcinoma. The preservation of the RHA is necessary to avoid ischemic complications but can impact margins resection in pancreaticoduodenectomy (PD). We report a case of a 53-year-old man with a head pancreatic carcinoma. There was a close contact between the tumor and the RHA arising from superior mesenteric artery (SMA). Preoperative embolization of the RHA was performed prior to PD.     

Cancer incidence and type of treatment hospital among children,adolescents, and young adults in Japan, 2016–2018

Cancer in children, adolescents, and young adults (AYAs) although rare, is the leading disease-specific cause of death in Japan. This study aims to investigate cancer incidence and type of treatment hospital among children and AYAs in Japan. Cancer incidence data (2016–2018) for those aged 0–39 years were obtained from the Japanese population-based National Cancer Registry. Cancer types were classified according to the 2017 update of the International Classification of Childhood Cancer (Third Edition), and AYA Site Recode 2020 Revision. Cases were also categorized into three groups: those treated at core hospitals for pediatric cancer treatment (pediatric cancer hospitals [PCHs]), those treated at designated cancer care hospitals, and those treated at nondesignated hospitals. The age-standardized incidence rate was 166.6 (per million-person years) for children (age 0–14 years) and 579.0 for AYAs (age 15–39 years) (including all cancers and benign or uncertain-behavior central nervous system [CNS] tumors). The type of cancer varied with age: hematological malignancies, blastomas, and CNS tumors were common in children under 10 years, malignant bone tumors and soft tissue sarcomas were relatively common in teenagers, and in young adults over 20 years, carcinomas in thyroid, testis, gastrointestinal, female cervix, and breast were common. The proportion of cases treated at PCHs ranged from 20% to 30% for children, 10% or less for AYAs, and differed according to age group and cancer type. Based on this information, the optimal system of cancer care should be discussed.     

Cancer treatment summaries and follow-up care instructions: which cancer survivors receive them?

Purpose

Medically underserved subgroups of survivors bear a disproportionate burden of cancer-related health problems. Treatment summaries and follow-up care instructions are one possible strategy to address disparities in cancer-related health among cancer survivors. However, it is not known which cancer survivors receive these documents. This paper sought to identify and describe patterns in the receipt of treatment summaries and follow-up care instructions.

Methods

Data from the Behavioral Risk Factor Surveillance System’s 2010 cancer survivorship module were used for this study. This study involved 6,897 adult cancer survivors. Multivariate logistic regression was used to test for associations between survivor’s demographic and cancer-related factors and receipt of treatment summaries and follow-up care instructions.

Results

Treatment summaries were received by 31 % of survivors. Demographic characteristics and type of health care provider were associated with treatment summaries (LR χ ² (31) = 101.02, p < .001). Follow-up care instructions were received by 71 % percent of cancer survivors. Survivors’ demographic and cancer-related characteristics were associated with follow-up care instructions (LR χ ² (31) = 231.51, p < .001). Written follow-up instructions were received by 66 % of survivors who reported receipt of follow-up instructions. Receipt of written follow-up instructions was associated with gender and age.

Conclusion

Demographic and cancer-related patterns exist in the receipt of treatment summaries and follow-up care instructions. These patterns map to documented gaps in survivor cancer-related outcomes. Research that tests associations between treatment summaries and follow-up care instructions and cancer-related health outcomes is needed.     

Primary lung clear cell carcinoma： one, case report

Case report The patient was male, 64 years old, admitted to hospi-tal due to Repeatedly cough for two months. Two months ago in the patients with no obvious incentive to appear repeatedly coughing, without sputum, no chest tightness,chest pain or fever symptoms such as.     

Two “childhood” malignancies in an elderly individual: a case report and discussion

Rhabdomyosarcoma (RMS) is the most common soft-tissue tumor in childhood, but is extremely rare in elderly. We present a rare case of cardiac RMS, which developed 1 year after the diagnosis and management of acute lymphoblastic leukemia in a 68-year-old female. The occurrence of such phenomena is intriguing, especially in an individual without prior history of malignancy at a younger age. Through the review of the existing literature, we attempt to approach the pathogenesis and clinical manifestations of this rare clinical entity.     

Comprehensive treatment of thyroid-stimulating hormone （TSH）-secreting pituitary adenoma： one case report

Thyroid-stimulating hormone (TSH)-secreting pituitary adenoma is a rare type in all pituitary tumors. Recently we treated a TSH-secreting pituitary tumor in our hospital. The patient had been treated for hyperthyroidism, in which methima-zole had been prescribed for 10 years, but the symptoms had not been alleviated. MRI imaging demonstrated the typical fea-tures of a sellar tumor, and the diameter was approximately 2.7 cm. Based on the laboratory studies: T3 at 6.27 nmol/L, T4 at 260.10 nmol/L, FT3 at 17.22 pmol/L, FT4 at 76.06 pmol/L, TSH at 9.93 Mu/L, the patient was diagnosed with a TSH-secreting pituitary tumor and central hyperthyroidism. After the patient was given octreotide for one week, he received resection of tumor via single-nostril transsphenoidal approach. After discharge, the patient received the radiation therapy two courses about 20 days. Through the comprehensive treatment of surgery, radiotherapy and drugs, the patient received a satisfactory result.